OBJECTIVES:

There were over 10,700 cases of melanoma and first-incidence non-melanoma skin cancer (NMSC) recorded in Ireland in 2013, with incidence rates increasing by 3-4% annually. We aim to identify hospital resource use at a national level, associated with these conditions.

METHODS: We obtained and analysed hospital episode statistics (HES) from the national Hospital Inpatient Enquiry (HIPE) service for all discharges with any diagnostic code C43.0-C43.9, C44.0-C44.9, C79.2 (ICD 10^th revision), from 2010 to 2014. This data captures daycase and inpatient activity for all patients in acute public hospitals in Ireland. Diagnosis Related Group (DRG) costs were taken from the 2011 Ready Reckoner published by the Health Service Executive inflated to 2017 prices. The data was analysed using Microsoft Excel.

RESULTS: There was a consistent increase in total discharges for patients with diagnostic codes C43 and C44 from 2010-2014. This increase was driven by an increase in daycase discharges; inpatient discharges decreased by between 6 and 9% annually. Highest numbers of discharges were for patients aged 65-84 years, in line with the epidemiology of melanoma and NMSC in Ireland. The most common adjacent DRGs for daycase discharges were J11 Other Skin, subcutaneous tissue and breast procedures, R64 Radiotherapy and J69 Skin Malignancy. The largest increase in daycase discharge DRGs was for R63 Chemotherapy, an average of 29% over the period 2011-2014. The most common adjacent DRGs for inpatient discharges were J11Z Other Skin, SC tissue and breast procedures, J69B Skin malignancy without CCCC, and J08B Other skin graft &/ debridement procedures –CC. The estimated cost for the day case and inpatient discharges was €44.88 million and €38.5 million respectively, over the 5 year period.

CONCLUSIONS:

Increasing incidence of melanoma and NMSC is reflected in increasing resource use in the hospital setting, primarily in the daycase setting. Limitation:HIPE excludes outpatient discharges.